Secret trove reveals bold ‘crusade’ to make OxyContin a blockbuster

Welch, West Virginia – The sales representatives of pharmaceutical giant health care Abbott Laboratories had a problem . No matter what they tried, they could get the attention of an orthopedic surgeon to convince prescribing potent analgesic OxyContin .

Week after week, they dropped by his office, sometimes bring lunch for the doctor and his staff. However, he had little time for them.

That is, until the staff let them in on a secret: “We were told by their nurses and office staff that the best way to capture their attention and develop our relationship was through junk food” sales representatives, wrote in an internal memo.

The following week, one of the representatives of Abbott appeared with a box of sheet cake full of donuts and cupcakes arranged to spell the word “OxyContin.” The first movement worked. The surgeon heard the sales talk, and every week after that, the sales staff Abbott visited the doctor to ask you to change at least three patients with other painkillers OxyContin.

The stratagem donut, said in a trove of internal documents obtained by STAT shows the lengths to which Abbott was to engage in medical and OxyContin to overproduce billion. The sales force bought dinners for carrying doctors and received in bookstores to pay for purchases. In the notes, the sales team which refers to the marketing of the drug as a “crusade” and his boss called himself the “King of Pain.”

Purdue Pharma LP, a Connecticut company that developed OxyContin, has been vilified by plant the seeds opioid crisis today, which kills an estimated 78 Americans a day. But Abbott’s role in pushing the drug has largely escaped notice measure. The documents reveal that it was a crucial partner in the aggressive – and misleading -. OxyContin sales during its first decade on the market

Abbott’s relationship with Purdue and its role in building the brand OxyContin are detailed in court documents released previously secret by a state judge Welch, West Virginia, at the request of STAT. The records were part of a case brought by the state of West Virginia against Purdue and Abbott alleged that improperly marketed the drug, causing users to become addicted to opioid. The case was settled in 2004 when Purdue agreed to pay $ 10 million for the state. Neither company admitted the allegations.

The documents include internal memos Abbott and Purdue, as well as sales documents and marketing materials. Show that sales representatives were instructed Abbott to minimize the threat of addiction OxyContin and make doctors who had no scientific basis other claims. Sales representatives of the two companies coordinate their efforts closely, they met periodically to create a strategy, and marketing materials are shared.

Abbott, a much larger company than Purdue, had a sales force entrenched in hospitals and surgery centers, and had existing relationships with anesthesiologists, emergency physicians, surgeons and pain management teams. Abbott dedicated at least 300 sales representatives for sales of OxyContin – about the same number of people Purdue initially dedicated to the drug -. As part of a co-promotion agreement with Purdue

Earn help Abbott was so important to Purdue agreed to indemnify the largest company in legal expenses arising from the sale of the drug. It was an arrangement that ended up saving millions of dollars from Abbott, and also kept the company out of the headlines as Purdue was forced to pay large fines and settlements illegal marketing of OxyContin.

Abbott declined to comment about the marketing techniques described in court documents, or reveal how much was paid by Purdue sell OxyContin. The only comment from a spokesman that he was “Abbott was indemnified by Purdue in demand.” Abbott no longer sells pharmaceutical products in the United States, after having split the business into a new company in 2013.

Illustration of a bulletin Abbott Laboratories domestic sales has sales executives of the company as members of the “Royal Court of OxyContin”, including sales director Jerry pain care Eichhorn as the “King of pain”.

Carrying the flag into battle OxyContin

Abbott marketed OxyContin from 1996 to 2002 – a critical period immediately after the approval of the drug by the Food and Drug Administration US

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With the help of Abbott, OxyContin sales were just $ 49 million in its first full year on the market for $ 1.6 billion in 2002. During the life of the association, Purdue Abbott paid nearly half a billion dollars according to court records.

At the end of the operation, it was one of OxyContin prescription opioids most consumed in the country and was responsible for a corresponding wave of addiction and crime from West Virginia to Maine to Florida. West Virginia has the highest rate of fatal overdoses in the country – and opiate abuse has expanded sales of analgesics more potent drugs such as heroin and fentanyl. Last month, the city of Huntington experienced 26 overdose in just a few hours.

Abbott strongly encouraged its sales staff to push OxyContin, offering $ 20,000 cash prizes and luxury holiday the best. Its almost religious zeal to sell drugs is evident in the extensive use of the terminology of the Middle Ages Crusades: Sales representatives were called the “true cross” and “gentlemen” in internal documents, and were supervised by the “Royal Court of OxyContin” – executives are referred to in the notes as the “Wizard of OxyContin”, “Supreme Ruler of pain Management” and the “Empress of Analgesia” sales chief for pain care, Jerry Eichhorn it was the “king of pain” and signed memoranda. simply as “the king.”

“As you continue to carry the flag of OxyContin on the battlefield, it is important to keep highlighting the benefits of OxyContin their doctors,” Abbott urged his sales staff in a memo contained in the records cut.

However, some of the benefits of the sales representatives were instructed to highlight lacked scientific support, and in some cases were similar to the claims made by Purdue.

In 2007, Purdue pleaded guilty to a criminal charge of misbranding OxyContin in an effort to confuse doctors and consumers. The company paid more than $ 600 million in fines.

A central charge in the Department of Justice United States if Purdue was that “sales representatives falsely told Some providers of medical care OxyContin was less than euphoric effect and less abuse potential short-acting opioids. ”

In a note Abbott, sales staff were instructed that if a doctor is concerned about the euphoria of a patient experienced over the painkiller Vicodin shorter action, must inform the doctor, “OxyContin has less effect.”

In another memo – this is a list of ideas to help sales staff to increase the percentage of prescriptions pill written pain by orthopedic surgeons OxyContin – Abbott told representatives of highlighting the “less abuse / addiction potential” of the drug, which could be taken just twice a day due to its extended release formulation.

representatives of Abbott also given a graph to show doctors that showed levels of the ingredient that kills the pain in the bloodstream is stable, but it seemed more “flat” levels were actually, according to court records. Using a similar graph it was cited in the federal case against Purdue as a key part of the evidence that falsely marketed OxyContin as having less euphoric effects and potential for abuse than short-acting opioids.

And a “road training” prepared by the sales staff Abbott advised to discuss the possible abuse of OxyContin only if a doctor mentioned it, and to tell the doctors that “road users” were misuse drug not “real pain patients.”

Lawyers for the state of West Virginia seized Abbott marketing materials as evidence the company misled doctors on the key issue of abuse.

” ‘King of Pain” Abbott taught his pseudoscience’ ‘real on OxyContin’ crossed minimize the risk of dependence, ‘and down the euphoria, “they wrote in a motion unsealed as part of the STAT request.” However, the ‘sale of salvia’ turns out to have a minimum knowledge of pharmacology, and admitted that he had no basis for making these statements passing along their ‘real’ “Crusaders.

Eichhorn, the official Abbott referred to as the “King of Pain,” did not respond to requests for comment. After monitor sales of OxyContin, which went on to become national sales and marketing director of Abbott. In 2013, when Abbott spun off its pharmaceutical operations into a new company called Abbvie, Eichhorn became the national sales manager of the new company, a job he still holds.

‘Dine and Dash’ and other sales tactics

Abbott sales force not lose opportunity to have access to busy doctors prescribe and make the court documents.

One method was a program called “Dine and Dash.” Sales representatives of the company would be pay for takeaways in a restaurant favored by a particular doctor. During the five minutes it normally given by the doctor to collect the food and the sales rep to pay for it, the employee of Abbott “detail” the physician, according to an internal memorandum sales. Detailing is a term of the pharmaceutical industry for the sale of a doctor on the benefits of a drug.

A similar technique involved inviting a surgeon to a book store, giving the doctor a coupon, and then details the doctor while waiting to pay. In addition to bringing lunches to doctor’s offices he was encouraged to representatives of Abbott to schedule afternoon cookie and candy snacks for offices as a way to promote goodwill with the “grateful” personal. Similarly, they were told sales staff to target nurses who were influential with doctors.

Creative tactics helped Abbott beat sales targets for OxyContin, winning “One-Eyed Jack rewards of lottery tickets to all crusaders” in 2000, according to a note of the company’s sales. The tickets were worth up to $ 20,000, according to the document. Sales representatives who achieved the highest growth in market share were promised travel to “a place worthy of a quest and conquest of the crusaders!”

The Abbott generated more sales, the higher the reward for the company, too. Under the agreement with Purdue, Abbott received 25 percent of all net sales, up $ 10 million for prescriptions written by doctors to their sales representatives calls, and 30 percent of sales of more than $ 10 million , according to court documents. Purdue deduct an unspecified amount of costs related to items such as transport and distribution.

Abbott declined to provide figures attorneys West Virginia showing their earnings OxyContin, according to court records, but documents obtained by the State in its application “show millions of dollars in profits to Abbott.”

In a 1997 document, an executive of the company indicated that prescriptions written by “Abbott MD” comprised 25 percent of all prescriptions of OxyContin. In addition, records Purdue budget obtained by the Florida Attorney General reveal details of payments to Abbott for his work OxyContin, called “commissions”. From late 1996 to 2002, Abbott paid about $ 374 million in commissions, according to the documents. Total sales of the drug during that time were almost $ 5 billion.

From 2003 to 2006, after Abbott had it stopped selling OxyContin still a residual payment received 6 percent of net sales, according to court records West Virginia. It is not clear if it belonged only to prescriptions written by doctors Abbott. OxyContin sales during that time were almost $ 6 billion.

Purdue was not shy to push his biggest to be more aggressive in their sales efforts partner.

In a note of July 1997, then vice president of Purdue Michael Friedman seven members of family Sackler who own Purdue, and other company executives that the company had “been Abbott pushing to increase its activity towards surgeons. “Friedman wrote that Abbott had responded with a” new emphasis on OxyContin and dedication of significant resources to this task. “

In an accompanying letter from an Abbott executive vice president of marketing at Purdue, Abbott promised to bring the relationship between the companies to “new heights with OxyContin our position as a key component of Abbott Pain Management”.

How Abbott remained below the radar

Compensation for legal costs proved to be a stroke of luck for Abbott and also saved from unflattering publicity. When the case of West Virginia was established in 2004, the state made no mention of Abbott when the deal was announced.

Similarly, when Kentucky settled a lawsuit last year against Purdue and Abbott who alleged the companies misrepresented the addictive nature of OxyContin and caused doctors to prescribe in excess, the announcement of the state attorney general left out Abbott. The case was settled by a payment of $ 24 million from Purdue.

Abbott is often called one of the accused in cases of Purdue on the alleged illegal marketing of OxyContin. In 2003, Abbott disclosed in its annual report that faced 306 lawsuits pending as a result of their activities OxyContin. However, the company noted that “Purdue is obliged to compensate Abbott in each claim.”

A dispute between Purdue and its liability insurer offers a look at the legal costs related to the process of phasing OxyContin. For 2006, Purdue claimed $ 400 million in fees and attorney fees for defending cases of OxyContin.

An auditor hired by the insurance company to review complaints Purdue reported that the pharmaceutical paid more than 70 law firms to defend about 1,400 cases. Law firms billed to 1.2 million hours of work, according to the audit. Purdue insurance company refused to pay the full amount and the parties finally reached a confidential settlement. Those amounts do not include the Purdue paid to resolve certain cases.

Purdue declined to comment on his compensation agreement with Abbott or the amount of the legal fees paid on behalf of your partner.

Sales representatives Abbott who devised the stratagem of junk food to win over reluctant orthopedic surgeon were held in an internal newsletter sent to Abbott sales team nationally. It was the first prize winner of a contest seeking the best cases of successful sales of OxyContin.

$ 250 “TravPass” were received as a reward, but the documents do not specify the value of the real world of award or how they could use the “dollars”.

“We are delighted that we have such a sweet in developing a relationship with this start,” no-see “doctor” sales representatives Abbott wrote in the bulletin, “and are looking forward to sweet success with OxyContin “